Wednesday, December 22, 2010

RE: Seto, Michael C., Hanson, R. Karl, & Babchishin, Kelly M. (in press). Contact sexual offending by men with online sexual offenses. Sexual Abuse: A Journal of Research and Treatment, first published on December 20, 2010 as doi:10.1177/1079063210369013

The influence -- one way or another -- of pornographic material on sexually or socially inappropriate behavior continues to perplex citizens, researchers, and social policymakers. The associated rhetoric often touches on cultural, moral, religious/spiritual, and political themes.

Some say that 80% or more of all internet traffic is related to pornography, but this seems unlikely. Nonetheless, it is clear that access to pornographic materials has become much much easier in the internet age. Unfortunately, this has also made it easier for those interested in child pornography to obtain access to images -- photos and videos -- that were previously relatively difficult to obtain. It seems almost weekly that we are told of law enforcement's efforts and successes in the battle against online child abuse and child pornography. Many jurisdictions now have tough penalties for those caught possessing, distributing, or creating child pornography. In some cases, the mandatory minimum sentences for possessing child pornography exceed the typical sentences given for contact offenses against children. Clearly, as a society, we take a very dim view of those who traffic in these sorts of materials.

But, what of the offenders?

In some respects, this may be a "chicken and egg" dilemma. Do pedophiles seek out child pornography or does downloading (and other subsequent activities best left to the imagination) of sexually explicit images of children lead to eventual contact (or "offline") offending with children? In other research, it has been suggested that surfing child pornography is a robust diagnostic indicator of pedophilic interests (see Seto, M. C., Cantor, J. M., & Blanchard, R. (2006). Child pornography offenses are a valid diagnostic indicator of pedophilia. Journal of Abnormal Psychology, 115, 610-615).

In a recently released, online first publication in the journal Sexual Abuse: A Journal of Research and Treatment, Mike Seto, Karl Hanson, and Kelly Babchishin attempt to answer some of these nagging questions. In two meta-analyses, they investigate 1. the contact offense histories of online offenders, and 2. the recidivism rates of online offenders.

In regard to the question of how many online offenders also have contact sexual offenses, Seto and colleagues found that only one in eight online offenders had officially-documented histories of contact offenses. However, this is tempered by their finding that more than half of such offenders are inclined to admit to contact offenses that are unknown to authorities; although, self-report data appears to have been available in only a small number of studies in the meta-analysis. Further, Seto et al. note that the controversial "Butner Study" was an outlier in finding significantly higher rates of self-reported contact offenses in online offenders. When they removed this study from the analysis, the rates of self-reported contact offending became more consistent, study to study.

The first statistic (1:8) seems consistent with the argument made by some offenders that they are only interested in the pictures, and that surfing internet child pornography meets their needs and helps them to refrain from engaging in contact offenses. However, the second statistic (50%) gets to the heart of our (SO professionals) fears that many of these guys are just not getting caught. Indeed, under-reporting has always been the fly in the ointment for all of us quoting statistics regarding sexual abuse rates, incidence or recidivism.

The second meta-analysis focused on reoffense rates. Seto, Hanson, and Babchishin found quite low rates of reoffending in the samples of online child pornography offenders: 4.6% of offenders engaged in new offenses over follow-up periods ranging from 1.5 to 6 years of follow-up, with 2% engaging in new contact offenses and 3.4% incurring new charges for online child pornography offending. Pretty low rates of reoffending all around; although, we must honestly note that the follow-up times are short.

So, what are we to take away from these findings?

Seto et al. address the issue of risk assessment with child pornography offenders. Presently, the Static-99 (a commonly used actuarial risk assessment scale) is not recommended for offenders with no documented history of contact offenses. However, this preclusion does not extend to other scales, such as the Sex Offender Risk Appraisal Guide (SORAG), but some have expressed concern with the general applicability of the standardization sample underpinning that scale (I am making no particular statement one way or the other here, by the way. Individual clinicians will need to review these instruments and make their own decisions). Regarding Static-99, Seto et al. suggest that if a high proportion of online offenders also have offline offense histories, then use of the Static-99 might be appropriate with this population, but only with modifications to the coding rules. This makes great sense and, given the rapidly growing numbers of online offenders before the Court, it would be helpful if risk assessors could add an objective measure of risk potential to their cadre of evaluation tools.

However, this question seems to be undercut to a degree by the findings of the second meta-analysis in this study. It would appear that, regardless of their histories of offline offending (officially known or self-reported), offenders who engage in online child pornography offenses are generally disinclined to reoffend. This causes Seto et al. to question whether there may be a "distinct subgroup of online-only offenders who pose relatively low risk of committing contact sexual offenses in the future". Of course, this has great implications for sentencing and risk management. Presently, many jurisdictions require online child pornography offenders to attend treatment and submit to community monitoring protocols similar to their contact offending compatriots. Given the findings of meta-analysis #2, does this potentially breach the tenets of the RNR model (i.e., overprogramming lower risk offenders by imposing treatment or management strategies that might not be specific to the needs of these particular offenders)? Seto et al. suggest that the risk factors may be the same for both online and offline offenders; however, the reoffense rates should give us cause to consider issues such as dosage and treatment methodologies. As such, we will need to have clear means of distinguishing who the higher risk guys might be.

In discussing their results, Seto, Hanson, and Babchishin suggest the existence of a subgroup of internet-only offenders who are disinclined to engage in contact offenses and who are at particularly low risk to reoffend in any sexual manner post-identification. At the very least, this suggestion should cause some to reconsider whether our current handling of these individuals is actually clinically or judicially appropriate. In order to best answer any nagging questions left standing, we as a field need to encourage and support additional research, scholarly discourse, and collaborative development of social policy.

Let me close this post with a quote from Seto et al.:

The low recidivism rates of online offenders may be used by some ... to minimize the seriousness of the online crimes committed.

I agree that it is important to acknowledge the greater issues of supply, demand, and exploitation that are part of the child pornography industry (if you can call it that). Clearly, efforts must continue to contain and eradicate this gut-wrenching problem. However, we must also take heed of the research findings regarding risk assessment and risk management of those involved.

A couple of weeks ago, I was working on a paper in which I needed to cite current statistics on the incidence of child sexual abuse by gender. I remembered having heard someone somewhere recently stating that the percentages had been updated. In asking a group of my colleagues, I got the usual one in four girls, one in seven boys, but these were the numbers I already knew and that most of us have been stating for years. That didn't answer my question as to whether these percentages had changed.

Alisa Klein from the Association for the Treatment of Sexual Abusers (ATSA) obviously has a good memory for these sorts of things, because some several days after my first query, she sent along the link above.

For many years, child sexual abuse professionals including those within Child Advocacy Centers have held to a similar mantra – one in four girls and one in seven boys are victims of sexual abuse or assault before the age of 18. These alarming statistics have been a rallying point for communicating the prevalence of child sexual abuse in the United States. While these statistics were absolutely true many years ago, we must ask ourselves two primary questions -- Are they still accurate? If not, what should we do?

I've been quoting the 1:4 / 1:7 statistics since quite early in my career, feeling relatively safe in the knowledge that these alarming numbers were pretty solid in the research. But of late, I've been focusing on other research that seems to suggest that things may be changing. A few years ago, David Finkelhor won ATSA's Significant Achievement Award for his tremendous contributions to our field. During his address, Dr. Finkelhor told us of his research regarding declining rates of child sexual abuse (Finkelhor & Jones, 2006; U.S. Department of Health and Human Services, 2009). I remember being shocked when he told us that rates had declined by 50% or more over the past quarter century.

Then, in the Spring of 2008, Andrew Harris from Public Safety Canada sent out an email asking for new Static-99 data sets, suggesting that declines in sexual recidivism had potentially rendered inaccurate the widely used outcome tables. It seemed that the tables were over-estimating risk, requiring empirical adjustment. Since that time, the Static-99 group has released new tables, but controversy remains as to how best to interpret such findings.

However, to get back on track, it would seem that these two related but not entirely related research streams should give us cause to think. My first thought was that this is really good news -- our efforts (vis a vis improved risk assessment techniques and advances in treatment best practices) are having an effect. However, the cynic in me asked whether there might be some other reason for these findings.

In workshops and classes I teach, I typically cite a number of reasons for decreased incidence of child sexual abuse and lower rates of reoffending:

Many of the people currently in positions of authority either came of age during the 60s or are the children of those people. While some may remember that period as being typified by hippies, free love, and flower power, we need to remember that it was also a period of incredible social change. Of greatest importance was the realization that, as people, we needed to pay better attention to how we regarded one another (equal rights) and how we interacted with one another -- particularly regarding interpersonal violence and how well we protected those among us who are more vulnerable.

The information age has helped us to get the message out to parents and citizens that there are things they can do to increase public safety.

Research as to how best to treat offenders (including what to focus on) has blossomed in the past 20 years, to the point that we now have a much better clue what to do to help our clients to refrain from further sexually abusive behavior.

We have much more effective tools for managing risk in the community (e.g., containment approaches, collaboration between stakeholders, Circles of Support & Accountability and other re-entry initiatives).

That's the perspective of Robin the Optimist. However, Robin the Not-So-Optimistic must concede that we have seen increases in both the rates of incarceration of offenders and the lengths of sentences they are assessed. In the USA, sexual offenders in almost half the states also face indefinite, involuntary civil commitment. So, it is also arguable that the rates of offending and abuse have also decreased because we have taken many of the riskiest offenders out of the risk pool.

Frankly, I like Chris Newlin's perspective better:

We have the data to support that two decades of coordinated efforts and resources are making a difference, so now we must adopt appropriate new messaging. "There are solutions that work, we are making incredible progress, and everyone has a role to play in efforts to end child abuse."

Nowhere in the piece does Chris actually suggest new statistics (although he hints that the ratios may have dropped). Rather, in closing his brief message, Chris suggests that we reframe our approach to the issue, in stating that the time has come for professionals to move out of "crisis mode" (in which we need to inform the public of the alarming statistics regarding child maltreatment and neglect) and to start trumpeting our successes and hope for continued advances in developing real solutions to this most troubling of social issues.

Tuesday, December 14, 2010

In her commentary, Dr. Franklin states that her interest "dissolved into disappointment when (she) realized that (my) response sidestepped substantive discussion of the new research (Wollert et al.'s new study on age-related desistance from continued engagement in sexual reoffending)".

Regarding my "side-stepping", I'm not sure that there was any "straight-stepping" (if that is the correct opposite) required. Dr. Wollert and crew quite admirably demonstrated that offenders, like the rest of us, slow down as they get older. The research is certainly important but not necessarily earth-shattering.

Dr. Franklin says, "The single most robust finding of two centuries of criminological research is that desistance from crime is near universal." She seems to agree with me, as I did with her.

Actually, I never set out to discuss the "new research" at all, as it is consistent with stuff that most of us in the field already accept to be true. Rather, the point of my blog was to question Dr. Franklin's approach in discussing it.

To close, I agree with Dr. Franklin in stating that, as bloggers, it is not our job to convince readers that we are the holders of divine truth. As she states, so I concur: Our job is to "encourage (objective--RJW) critical reflection and stimulate people to read the original source material," which I sincerely hope you will all endeavor to do.

Wednesday, December 8, 2010

Let me say first that it is not my intention to initiate some kind of a blog war. But, I read something recently in another blog that caught my attention and that probably requires a comment or two (or six).

Actuarial risk assessment scales for sexual and other offenders started to appear in the early to mid 1990s. The Violence Prediction Scheme (an early precursor to the VRAG and SORAG) arguably got the ball rolling, although the LSI was already in existence at the time. It has been claimed that the Static-99 is the most widely used sexual offense risk assessment scale on the planet, which may indeed be true, but it is hardly the only instrument of its kind. Most sexual offender evaluators use at least one of the more popular scales in their assessments of offenders.

Use of these scales is based on the premise that certain factors that, when clustered together, are predictive of who is at higher risk to reoffend. The more factors you have, the higher your risk or, at least, that's the thought. Items are typically chosen through a process of meta-analysis of factors reported in the primary research literature. As I already noted, various scales exist, but the majority of the factors included in them are roughly the same, largely because they are constructed using the same primary research literature. The two biggie factors appear to be sexual deviance and antisociality. Take your pick: SORAG, MnSOST-R, Static-99, etc. -- they all look pretty similar once you get past the idiosyncratic wording of items.

So, back to the other blog...

Dr. Franklin has something of a penchant for the flamboyant. Actually, I often appreciate a bit of bluster, but I think we also need to avoid bias and unnecessary sideswipes at our colleagues. In the spirit of honesty, let me say that I work in a civil commitment center and that I am a certified trainer for the Static-99 group of measures. So, my potential bias is on the table. Let me also say, however, that my work in the civil commitment center is aimed fully at making sure that my residents have the best treatment opportunities available so that they may have a reasonable chance at returning safely to the community to live a balanced, self-determined lifestyle free of future harm to others or themselves. As far as the Static-99 is concerned, as soon as someone shows me a tool that does the job markedly better, I'll jump ship and start using that one.

In her recent blog, Dr. Franklin suggests that her colleagues presenting on actuarial risk assessment at this fall's ATSA conference are "self-appointed gurus". Really, Dr. Franklin, is that actually a fair appraisal? The main personalities in the Static-99 world have contributed immeasurably to our (better) understanding of sexual deviance and risk to the community. I see no good reason to view them as anything other than well-intentioned, honest, and diligent scientists. That others may see them as "gurus" is not of their conscious efforts but, rather, a byproduct of the good work they have done. As far as I can tell, almost every person associated with the Static-99 group has worked hard to demonstrate both the strengths and weaknesses of the methodology and the scale itself. Not a one of them has ever overstated the value of the method or the tools they tout. Dr. Franklin rightly notes that these instruments are freely available on the net. We should also note that research as to their utility is vigorously encouraged.

For the record, all of the research to date suggests that tools of this nature have, at best, moderate predictive accuracy in helping us assess who is or is not likely to reoffend. I'm confused by Dr. Franklin's suggestion that we should use random sampling in the construction or validation of actuarial risk measures. What is it that we should be sampling randomly? The items? The subjects we score on the resultant scale? I may have missed something, but it seems to me that we should rather intentionally seek out those factors best predictive of future offending and that we should use these scales on persons who demonstrate at least some propensity for future offending. Neither of these seems well suited to a random approach.

As to the psychometric properties of the Static-99, I find it curious that Dr. Franklin only takes shots at this particular scale. As I noted above, there are many others available and given that they all sample from the same item pool and are subject to the same foibles and limitations, why not pick on the whole mess of them? What applies to Static-99 applies equally to them all. No risk assessor in his or her right mind should ever view a score (and risk rating) on an actuarial scale as being the only thing you need to know in evaluating a sexual offender's propensity for recidivism. They are tools found in a much larger toolbox of useful protocols/data/etc. you need to consider in providing comprehensive assessments of risk.

I also find it curious that Dr. Franklin labels the Static-99 as unreliable. The research I've seen suggests that it is particularly reliable -- guys who score higher reoffend more often than guys who score lower. This appears to be so no matter where the scale is used. Further, inter-rater reliabilities reported by various researchers have strongly suggested that, when using the coding rules, different assessors come up with the same score on the same guy most of the time. Overestimating risk is not a reliability issue, it's a validity issue -- one that we've already acknowledged in saying that the scale gives us only moderate predictive accuracy.

Andrew Harris (perhaps, somewhat cynically) opined the following:

Since we know from the literature that without the use of actuarials people tend to greatly over-estimate risk – and since all good ATSA members would support the use of actuarials, are we not cheap shills for the defence? The fact remains that a well done sex offender risk assessment is almost without exception a great aid to the offender.Here we have a member of the Static-99 group encouraging us to use actuarials to combat the sort of generalized tendency towards overestimation of risk that Dr. Franklin lamented in her blog. The last sentence of Dr. Harris' comment is simply brilliant. Maybe, what Dr. Franklin should be highlighting more is the fact that some evaluators are falling prey to partisan concerns. A "well done sex offender risk assessment" should say the same thing, regardless of who you are working for.

As for the effects of aging on reoffense risk, Dr. Franklin's comments are very much in line with my thinking and that of others in the Static-99 group. Indeed, the Static-99R exists solely because of a revised age-weighting that attempts to account for this effect. Too bad Dr. Franklin didn't note that a good bit of the research and discussion regarding this aging-out phenomenon, as it relates to sexual offenders, was instigated, led, or encouraged by members of the Static-99 group.

Thursday, December 2, 2010

The concept raised was whether or not there could be any benefit to "paying" sexual offenders to attend treatment. One of the persons posting suggested that it was an idea worth piloting.

Well...Let me wade into this.

Approximately 10 years or so ago, the Correctional Service of Canada initiated a process for community-based programs in which offenders (including sexual offenders) on conditional release received $5.00 per group they attended. As the former Chief Psychologist for the community in the Ontario Region, I had first hand experience of this practice. Let me first say that I thought it was a great idea. I saw it as a token acknowledgement of the efforts our participants made in attending programs. Sure, if they didn't attend they could go back to jail, but that was not the point. The National Parole Board had deemed them ready to release, and I saw it as our job to work collaboratively to keep them out, not find ways to put them back in. In some respects, I think this paying guys issue is in line with the broader concept of increasing offender responsivity in treatment. Bottom line: More guys attended more often. Of course, CSC scrapped the program because of "optics" but, while it operated, I think the impact was eminently congruent with our ultimate goal.

Actually, I liked this idea so much that when I moved to Florida, I thought we should try it there, too. However, with a twist. We have a small population of men with severe and persistent mental illness which, ultimately, presents a quite potent barrier to their engagement in comprehensive treatment programming for persons who have sexually offended. Essentially, being floridly psychotic and failing to meet basic activities of daily living gets in the way of understanding lifestyle dysfunction and problematic behavior -- and, ultimately, getting better enough to complete treatment and go home. Too many of our guys were sleeping the day away or languishing in front of the television while we were trying to get them into groups.

So, this was my thought... Why don't we pay them to attend psychotherapy and to attend to their ADLs? We pay other residents to perform various employment tasks, why not see getting better as their primary task or "job"? Sort of like making good mental health the project goal and paying them for attending to issues related to meeting that goal. We started paying each mental health unit resident 25 cents for every group he attends, to a weekly maximum of $5.00. Not much in the way of cost, but check out the Bottom line: Residents started getting up, engaging in morning exercises, showering, and preparing themselves for the day. Group participation increased dramatically, and we ultimately decreased the population of SPMIs in our residential mental health unit by a full third. Many of those discharged residents are now participating fully in our comprehensive treatment program.

Make of these examples what you will, but I am still a strong supporter of the concept. If our ultimate goal is to assist these persons in establishing the sort of balanced, self-determined lifestyles that are incongruent with continued antisociality and hurtful/harmful sexual behavior, any step is the right direction is a step towards harm reduction.

Like many people in our field, a long day's work sometimes leaves me psychologically and emotionally drained. One thing I do to unwind is watch mindless television. Unfortunately, I also have a somewhat lurid and voyeuristic side that draws me to shows like Criminal Minds, Law & Order, etc. Actually, I stopped watching L & O after they diagnosed a woman with Pedophilia using a PET scan. However, I made an exception last night, but only because Merissa Morin (daughter of ATSA member John Morin and stepdaughter of ATSA Board member Jill Levenson) was appearing on SVU. Thankfully, there were no wild applications of half-baked psychology. Merissa did a good job.

But, to get back on track...

This past weekend, I was catching up on old episodes of Criminal Minds and two of them threw me into a tizzy. In one episode, they referred to a guy as an "Anger/Excitation Rapist". When are we finally going to put this tired and outdated nomenclature to rest? I'm pretty sure that Ray Knight (often in combination with Robert Prentky) convincing blew that typology away in the late 1990s or early 2000s. In the other episode, the Dave Rossi character (Joe Montegna) referred to a serial killer who was targeting 16-18 year old girls as a "Hebephile". My outburst was so dramatic that the cat leaped off the bed!

I get it that the field is still trying to come to grips with diagnostic frameworks and typologies, with the proposed Paraphilic Coercive and Pedohebephilic disorders causing quite a stir. In truth, many parties make quite legitimate points for and against these proposed diagnoses. However, can whoever is advising these television shows please take the time to read a little bit??

Last point before I put this to rest...

This week, infamous Canadian child killer Clifford Olson was again denied release by the Canadian National Parole Board. Duh. However, what gets me is that the tabloid media seems obsessed with misleading the public into believing that he actually had a chance of getting out. In Canadian law, a "life" sentence is just that -- a life sentence; like, until you die. Parole "eligibility" is also just that -- eligibility. Just because someone might be eligible does not mean that he/she will actually be released (and, even once released on parole, an offender serving life can be returned to prison at the slightest sign of trouble). It doesn't take a lot of brain power to realize that no Parole Board member in his/her right mind is ever going to release Canada's most notorious child murderer.

Kieran McCartan, PhD

Chief Blogger

David Prescott, LICSW

Associate blogger

Translate

The Association for the Treatment of Sexual Abusers (http://atsa.com/) is an international, multi-disciplinary organization dedicated to preventing sexual abuse. Through research, education, and shared learning ATSA promotes evidence based practice, public policy and community strategies that lead to the effective assessment, treatment and management of individuals who have sexually abused or are risk to abuse.

The views expressed on this blog are of the bloggers and are not necessarily those of the Association for the Treatment of Sexual Abusers, Sexual Abuse: A Journal of Research & Treatment, or Sage Journals.

Disclaimer

ATSA does not endorse, support, represent or guarantee the completeness, truthfulness, accuracy, or reliability of any Content posted. ATSA does not necessarily or automatically endorse any opinions expressed within this blog. You understand that by reading this blog, you may be exposed to content or opinions that might be offensive, harmful, inaccurate or otherwise inappropriate. Under no circumstances will ATSA be liable in any way for any Content, including, but not limited to, any errors or omissions in any Content, or any loss or damage of any kind incurred as a result of the use of any Content or opinions posted, emailed, transmitted, or otherwise made available via this blog.